Objectives: The purpose of this study was to develop a working model to explain medical specialty decision-making. Using Social Cognitive Career Theory, we examined personality, medical specialty preferences, job satisfaction, and expectations about specialty choice to create a conceptual framework to guide specialty choice decision-making. Methods: Using an existing data set, the authors examined data on personality and medical specialty preference gathered from physicians (n=49). Personality was assessed using Personality Research Form (PRF) and Myers-Briggs Type Indicator (MBTI). The Medical Specialty Preference Inventory (MSPI) assessed preference for six medical specialties. The authors also inquired about expectations for specialty choice and job satisfaction using survey research. Physicians responded utilizing a Likert scale to six statements regarding job satisfaction. Participants were asked to respond to questions about their expectations and the actual practice of their specialty. Results: Data analyses using Pearson R indicated no significant relationship between PRF factors and job satisfaction. Chi-square results of MBTI and specialty choice regarding job satisfaction were not significant. Chi-square results of the MSPI and job satisfaction were also not significant. Qualitative comments provided by participants about expectations and actual practice of specialty helped to explain level of job satisfaction. These comments were categorized into twenty different themes. "Personal Reward/Satisfaction," "Time Commitment to Medicine" and "Balancing Personal and Professional Life" offered current contextual influences on specialty choice behavior. Conclusions: Medical specialty decision-making has long been a perplexing process for medical students and behavioral researchers. This study looked to Social Cognitive Career Theory to explain the complex interplay between personality, specialty preference, job satisfaction and expectations regarding each of these influences individually on specialty choice and job satisfaction, no significant results were found. A conceptual model is proposed and preliminary results support further testing of the model for medical specialty decision-making.